Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania

Abstract

ObjectiveTo determine cervical cancer screening coverage and the knowledge, attitudes and barriers toward screening tests among women in rural and urban areas of Tanzania, as well as explore how they view the acceptability of the HPV vaccine and potential barriers to vaccination.SettingA cross-sectional study using interview-administered questionnaires was conducted using multistage random sampling within urban and rural areas in Kilimanjaro Region, Tanzania.ParticipantsWomen aged 18–55 were asked to participate in the survey. The overall response rate was 97.5%, with a final sample of 303 rural and 272 urban dwelling women.Primary and secondary outcome measuresDescriptive and simple test statistics were used to compare across rural and urban strata. Multivariate logistic regression models were used to estimate ORs and 95% CIs.ResultsMost women (82%) reported they had heard of cervical cancer, while self-reported cervical cancer screening among women was very low (6%). In urban areas, factors associated with screening were: older age (OR=4.14, 95% CI 1.86 to 9.24 for ages 40–49, and OR=8.38, 95% CI 2.10 to 33.4 for >50 years), having health insurance (OR=4.15, 95% CI 1.52 to 11.4), and having knowledge about cervical cancer (OR=5.81, 95% CI 1.58 to 21.4). In contrast, among women residing in rural areas, only condom use (OR=6.44, 95% CI 1.12 to 37.1) was associated with screening. Women from both rural and urban areas had low vaccine-related knowledge; however, most indicated they would be highly accepting if it were readily available (93%).ConclusionsThe current proportion of women screened for cervical cancer is very low in Kilimanjaro Region, and our study has identified several modifiable factors that could be addressed to increase screening rates. Although best implemented concurrently, the availability of prophylactic vaccination for girls may provide an effective means of prevention if they are unable to access screening in the future.

Knowledge, Attitudes and Behavior of Bangkok Metropolitan Women Regarding Cervical Cancer Screening

“…Reports from suburb area of Thailand found 33% or 35% of 'never had' screening (Kritpetcharat et al, 2003;Wongwatcharanukul et al, 2014). In capital cities of other countries, the rates of 'no screening' varied widely from 15-90% (Claeys et al, 2002;Al Sairafi and Mohamed, 2009;Baskaran et al, 2013;Núñez-Troconis et al, 2013;Cunningham et al, 2015). Aside from the 35% of 'never had' screening, 18% and 4% of Bangkok women had only one test or the last test was more than 5 years, making up 57% of the inadequate screening in our study.…”

“…Focusing on the reasons why women did not have cervical cancer screening, reports from many countries had various findings (Tran et al, 2012;Baskaran et al, 2013;Núñez-Troconis et al, 2013;Cunningham et al, 2015). Several basic characteristics of the women may result in various reasons, such as, education, obstetrics and gynecologic history, and familial or cultural background, etc.Studies from South America, Africa and Asia reported that absence of symptoms, no knowledge, lack of time, embarrassment, fear of pain, anxiety on privacy violation and fear of infection, etc.…”

Kesediaan Mendapat Vaksinasi Human Papilloma Virus pada Remaja Putri Di Yogyakarta

“…12,13 Kesediaan vaksinasi pada wanita usia produktif di Tanzania 93% dan pada perawat di Nigeria 90%. 1,14 Di Indonesia, 96,1% orang tua bersedia anaknya divaksinasi. 15,16 Para remaja di Yogyakarta beralasan perlu berdis- 10 Persetujuan orang tua adalah hal yang sangat penting.…”

“…Namun, informasi yang salah akan menyebabkan persepsi negatif sehingga kesediaan vaksinasi rendah. 1 Penelitian di Spanyol dan Jerman menunjukkan situs laman tentang vaksin HPV sebagai sumber informasi yang sering diakses. Situs laman tersebut memberikan info kurang berimbang tentang kelengkapan, transparansi, dan dimensi infeksi HPV serta vaksinasi HPV.…”

“…5 Penelitian menunjukkan pemberian vaksin HPV dapat memberikan proteksi 89%. 1 Vaksin HPV efektif mencegah kanker serviks dengan cakupan vaksinasi yang bervariasi. Pada umumnya belum optimal, baik untuk inisiasi vaksinasi maupun kelengkapan dosisnya.…”